John Wheeler welcomes Benjamin Hernandez of Skytale for a high-level, practical conversation on medical aesthetics M&A, private equity, and what makes a med spa business attractive to buyers. Benjamin explains Skytale’s role as a healthcare-focused investment banking, management consulting, and private capital firm, and shares how the team has completed more than 20 aesthetics deals since the early stages of consolidation.

Benjamin traces the market from the 2021 and 2022 “gold rush,” when private equity had record levels of dry powder and the medical aesthetics space was still highly fragmented, into the more complicated environment that followed. Rising interest rates, inflation, recession concerns, increased competition, deeper diligence, provider risk, and changing patient spending patterns all forced buyers and sellers to become more disciplined. John adds the platform perspective, explaining how leverage works, why debt-to-EBITDA ratios matter, and how busted covenants can stop acquisition activity almost overnight.

The conversation also explores GLP-1 revenue and why it has made some med spa deals harder to underwrite. John and Benjamin both acknowledge the broader value of GLP-1s, while explaining why buyers get nervous when too much of a practice’s revenue depends on a service that may be exposed to regulation, commoditization, or pen stroke risk.

From there, John and Benjamin define what a great business looks like. Benjamin points to clean financials, useful KPIs, patient retention, employee and provider retention, low provider concentration, revenue quality, and strong unit economics. John adds partner chemistry, post-transaction ambition, healthy margins, year-over-year growth, culture, scale, and a founder who wants to keep building rather than disappear after the check clears.

Throughout the conversation, one message stays clear: today’s best aesthetics businesses are not built for a quick exit. They are built with discipline, durability, leadership, and a clear understanding of what future partners will value.